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Electromagnetic stimulation for overactive bladder in myelomeningocele children: randomized controlled trial
Heba A Khalifa1,2, Walaa E Heneidy3, Mostafa Abdelrazek4
1Department of Physical Therapy for Neurology and Neurosurgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Insights
Pulsed electromagnetic stimulation (PEMS) effectively treats neurogenic overactive bladder in children with myelomeningocele (MMC). Adding PEMS to standard therapy improved bladder function and reduced incontinence, enhancing quality of life.
Area of Science:
- Pediatric Urology
- Neurogenic Bladder Management
- Biomedical Engineering
Background:
- Myelomeningocele (MMC) frequently causes neurogenic overactive bladder, leading to urinary issues and reduced quality of life in children.
- Symptoms include urinary urgency, frequency, incontinence, and recurrent urinary tract infections.
Purpose of the Study:
- To evaluate the efficacy of pulsed electromagnetic stimulation (PEMS) as an adjunct therapy for neurogenic overactive bladder in children with MMC.
- To assess PEMS's impact on urodynamic parameters and incontinence episodes.
Main Methods:
- A randomized controlled trial involving 40 children (ages 4-12) with MMC and neurogenic overactive bladder.
- Participants received either standard anticholinergic treatment plus sham PEMS or standard treatment plus active PEMS, three times weekly for three months.
- Outcomes measured included urodynamic studies (UDS) and daily incontinence scores, assessed at baseline and post-intervention.
Main Results:
- The active PEMS group showed significant improvements in UDS variables, including increased detrusor leak point pressure, maximum cystometric capacity, and first uninhibited detrusor contraction volume.
- Daily incontinence scores significantly decreased in the active PEMS group compared to the sham group.
- These findings indicate enhanced bladder control and reduced incontinence with PEMS.
Conclusions:
- Pulsed electromagnetic stimulation, when added to conventional therapy, demonstrates significant efficacy in managing neurogenic overactive bladder in children with MMC.
- PEMS offers a promising therapeutic option for improving bladder function and quality of life in this pediatric population.
Background:
Myelomeningocele (MMC) is a congenital anomaly associated with neurological and urological complications, including overactive bladder. Overactive bladder is manifested by symptoms such as urgent and frequent urination, incontinence, and recurrent urinary tract infection, all of which can negatively affect children's quality of life.
Aim:
To investigate the efficacy of pulsed electromagnetic stimulation on overactive neurogenic bladder in MMC children.
Design:
Randomized controlled trial.
Population:
Forty children with MMC and overactive neurogenic bladder.
Methods:
Children were recruited and allocated randomly into two groups of equal sizes; their ages ranged from four to twelve years. The sham PEMS group received standard anticholinergic medical treatment and sham pulsed electromagnetic stimulation for 20 minutes, while the real PEMS group received active pulsed electromagnetic stimulation (PEMS) for 20 minutes along with the same medical treatment as the sham group. For each group, treatment was delivered three times/week for three consecutive months. Urodynamic studies (UDS) were conducted, and daily scores for the frequency and severity of incontinence episodes were recorded. All the measured outcomes were evaluated at baseline and three months post-intervention.
Results:
After treatment, UDS variables increased significantly in the real PEMS group compared to the sham PEMS group; detrusor leak point pressure increased, as did maximum cystometric capacity, expected maximum cystometric capacity, and first uninhibited detrusor contraction volume, while daily incontinence scores significantly decreased.
Conclusions:
Adding pulsed electromagnetic stimulation to conventional therapy was associated with controlling neurogenic overactive bladder in MMC children.
Clinical Rehabilitation Impact:
Pulsed electromagnetic stimulation has a notable effect on the neurogenic overactive bladder in MMC children.
